A murky practice at the NHS

According to a recent investigation by the Daily Telegraph newspaper, hundreds of NHS officials responsible for assessing which drugs should be prescribed to patients are on the payroll of pharmaceutical and medical device companies.  Several companies have been flying NHS staff abroad and hosting meetings in luxury hotels. It is not unusual for NHS officials to take roles in medicines management and act as consultants to pharmaceutical firms, sometimes advising companies on how to sell medicines and products to the NHS. This creates a clear conflict of interest, and even though there may be no wrong doing, the perception of conflict of interest counts in the conduct of all holders of public office.

The Health Secretary Jeremy Hunt has promised to introduce a ‘Sunshine Rule,’ modelled on the US Sunshine Act, making it mandatory for health care workers to declare any gifts from Pharma companies.  The Sunshine Rule will come into force later this year. All NHS organisations will be expected to keep up to date registers of gifts and hospitality received from Pharma and Medtech companies.  Clinical Commissioning Groups (CCGs) are legally required to keep a conflict of interest register and have anti-bribery procedures in place.  Research shows that there is little uniformity in the approach of these groups to anti-corruption policy and safeguards.    The new Sunshine rule, though a step in the right direction, will add to the confusion. There is too much guidance and not enough clear instruction for NHS staff.  What is needed are updated policies which take into account current NHS documents, the Bribery Act, the Nolan Principles and the Sunshine Rule.  There has to be consistency in documentation, and a mandatory set of forms that are accessible to the public.  And any guidance and documents must be prepared in collaboration with the medical and pharmaceutical profession, such as the ABPI, again to ensure consistency in reporting.  This will create transparency in this murky practice, and any NHS staff attempting to influence purchasing decisions in return for payment, gifts or hospitality can be held accountable.